Individual
DR. JONATHAN PAUL SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8036
(860) 679-4100
(860) 679-1064
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8036
(860) 679-4100
(860) 679-1064
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
269626
MA
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
55313
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110128968A
—
MA
Enumeration date
04/03/2007
Last updated
07/28/2025
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